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�SA668-C2B�81 o_ez APPLICATION F ELECTRI AL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS S�
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. TOTAL NO. EACH FEE
OUTLETS FIRST ZOUr $.20 $ Ml OWNER
LIGHT MAIL
ADD'L ADDRESS
OVER
SWITCH. ZO .10
LIGHTING
TOTAL 8 iS CITY TEL.NO.
FIRST ZO .20 O Cl
FIXTURES ADD'L OVER ZO 10 ELECTRICIANjh
.
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS W
GARB.DISP. STA.COOKQ/
CITY TEL.NO. Q Ip
DISHWASH. AUTO.-WASH. STATE / /j /J �+
SPACE HTRS. STA.A .('A H.P.MAX.) .s0 LICENSE NO. (7 C1 1J Q
MOTORS: OVER NOT OVER H.P. DIST ICS NO. GROUP ONE• SSED B
O 1 1.00
1 s 1.50 INSPECTION RECORD
S a 2.00 -Wf'PJ-- nLe-A All&L &OLLAC72
,-0964 d
8 is 2.50 0
,S
15 so 3.00 a:
so 100 moo ' •y�y.
SIGNS- NO.TRANS. c'
NO.LAMPS
SERVICE 0.60OV-Nor OVER 200A 1.00
SERVICE 0-600V-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE J
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING fi +.t.Q.RJ2R. S.
I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES Q t '+ Al t -AA..*
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPEk7Y. POWER h
SIGNATURE UTILITY CO.NOTIFIED P-2-4 _
OF PERMITTEE
FINAL Z� � i[�.f-1 t.t(:U'C.tAitZI
/VALIDATION ARTHUR C. VEIT- V
l(CK MO CASH SUPERVISING ELECTRICAL ENGINEER
LACO 1 7 9 7 MAY 19 2 D 1 5.2 Q- # ,